Early Clinical Efficacy Comparison Study of Gamma3 Nail, Percutaneous Compression Plate (PCCP) and Femoral Head Replacement (FHR) Treatment on Senile Unstable Intertrochanteric Fractures

Yang, Shaofeng; Liu, Yanan; Tong-qi, Yang; Zou, Jun; Yang, Huilin

doi:10.1080/08941939.2017.1282558

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…The selection of internal fixation and the technique of the clinician may be the main reasons for the high heterogeneity. Yang 20 points out that the percutaneous compression plate has more intraoperative blood loss and longer operation time than Gamma3. Prolongation of operation time and increase in intraoperative bleeding will increase the risk of wound infection.…”

Section: Discussionmentioning

confidence: 99%

Internal Fixation versus Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and Meta‐Analysis

Liu

et al. 2020

Orthopaedic Surgery

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Objective To evaluate the clinical efficacy of internal fixation versus hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly. Methods A search was conducted in PubMed, Web of Science, Embase, and Cochrane Library databases up to April 2020. The present study compared internal fixation and hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly. RevMan5.3 software provided by the International Cochrane Group was used for the meta‐analysis. To compare the differences in the operation time, intraoperative bleeding, length of hospital stay, superficial infection, Harris hip score, mortality within 1 year, mortality within 2 years, reoperation, incidence of deep venous thrombosis (DVT), partial weight‐bearing time, non‐union, and implant‐related complications between an internal fixation group and an hemiarthroplasty group. Results A total of 1300 patients were included in nine studies. The results showed that the operation time (MD = −18.09, 95% CI: −27.85–−8.34, P = 0.0003), intraoperative bleeding (MD = −195.31, 95% CI: −244.8–−147.74, P < 0.0001), implant‐related complications (MD = 3.83, 95% CI: 1.74–8.45, P = 0.0008), and partial weight‐bearing time (MD = 17.21, 95% CI: 1.63–32.79, P = 0.03) have statistical significance. However, there is not statistical significance for the Harris hip joint function scale (HHS) (MD = 5.60, 95% CI: −1.13–12.33, P = 0.10), DVT (MD = 1.02, 95% CI: 0.45–2.27, P = 0.97), length of hospital stay (MD = ‐1.08, 95% CI: −2.82–0.66, P = 0.22), superficial Infection (OR = 0.92, 95% CI: 0.43–1.98, P = 0.89), mortality within 1 year (OR = 0.95, 95% CI: 0.61–1.48, P = 0.81), mortality within 2 years (OR = 0.93, 95% CI: 0.61–1.43, P = 0.75), reoperation (MD = 1.80, 95% CI: 0.64–5.04, P = 0.26), and non‐union (OR = 1.20, 95% CI: 0.48–3.03, P = 0.70). The result of the subgroup analysis showed no significant differences between the less than 2 years follow‐up and the 2 years or more follow‐up group. The only difference was for the Harris hip score: the internal fixation group was superior to the hemiarthroplasty group in the less than 2 years subgroup analysis, while there was no difference between the internal fixation group hemiarthroplasty group in the 2 years or more subgroup analysis. Conclusion Compared with the internal fixation group, those in the hemiarthroplasty group could carry out weight‐bearing training early and implant‐related complications were reduced, but it requires longer operation time and there is greater intraoperative blood loss. There is no difference in mortality, the incidence of DVT, non‐union, HHS, reoperation, length of hospital stay, and superficial infection. Hemiarthroplasty may be a better choice for unstable intertrochanteric fractures in the elderly.

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Section: Discussionmentioning

confidence: 99%

Internal Fixation versus Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and Meta‐Analysis

Liu

et al. 2020

Orthopaedic Surgery

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“…However, osteoporosis and cognitive dysfunction of patients still remain major causes of fixation failure as they may make it difficult to achieve strong fixation in the fracture site and interfere with early ambulation 4 , 5) . Consequently, although still debatable, arthroplasty may be considered a preferred approach for treating unstable intertrochanteric fractures 10) .…”

Section: Introductionmentioning

confidence: 99%

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

et al. 2018

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PurposeThis study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies.Materials and MethodsSystematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types.ResultsThere were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03).ConclusionCemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.

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“…Probably, internal fixation will act as the treatment of mainstay for intertrochanteric fractures in the coming future. High mortality is closely associated with the fracture itself [10], and surgeons cannot alter any objective factors, such as advanced age, systemic comorbidity and fracture fashion. However, we can struggle to take more active treatment mode to reduce injuryto-surgery interval, improve operation quality, provide comprehensive therapy and prevent early lethal complications such as pneumonia and cerebrovascular accidents.…”

Section: Quite Difficult!mentioning

confidence: 99%

“…The care of IFFs should be patient-centered, but not fracture-centered, through comprehensive evaluation of potential risks and swift establishment of treatment protocol simultaneously. By means of fracture fixation or hip arthroplasty, fractured patients had better to leave bed and regain ambulation as early as possible [4].…”

mentioning

confidence: 99%

Commentary on “Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty”

Gao

2017

Journal of Investigative Surgery

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Early Clinical Efficacy Comparison Study of Gamma3 Nail, Percutaneous Compression Plate (PCCP) and Femoral Head Replacement (FHR) Treatment on Senile Unstable Intertrochanteric Fractures

Cited by 8 publications

References 18 publications

Internal Fixation versus Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and Meta‐Analysis

Internal Fixation versus Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and Meta‐Analysis

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

Commentary on “Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty”

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